Utility of chest ultrasound and intrapleural fibrinolytics with gentamicin following failed pleurodesis

This is a case of a 65-year-old male patient who presented to our institution due to worsening dyspnea and respiratory failure development. The patient was admitted due to dyspnea at rest and chest pain. He had a recent medical history of lung cancer with malignant pleural effusion. The patient had...

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Main Authors: Aldo Pezzuto, Ferdinando Cozzolino, Giosuè Amoroso, Evohe Adone, Elisa Desideri, Alberto Ricci
Format: Article
Language:English
Published: PAGEPress Publications 2025-05-01
Series:Monaldi Archives for Chest Disease
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Online Access:https://www.monaldi-archives.org/macd/article/view/3224
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author Aldo Pezzuto
Ferdinando Cozzolino
Giosuè Amoroso
Evohe Adone
Elisa Desideri
Alberto Ricci
author_facet Aldo Pezzuto
Ferdinando Cozzolino
Giosuè Amoroso
Evohe Adone
Elisa Desideri
Alberto Ricci
author_sort Aldo Pezzuto
collection DOAJ
description This is a case of a 65-year-old male patient who presented to our institution due to worsening dyspnea and respiratory failure development. The patient was admitted due to dyspnea at rest and chest pain. He had a recent medical history of lung cancer with malignant pleural effusion. The patient had already undergone pleural talc poudrage by thoracoscopy, which had not been effective. Indeed, the patient was found to have residual septate pleural effusion on ultrasound examination. A placement of transthoracic pleural drainage followed by intrapleural instillation of urokinase (100,000 units) and gentamicin (80 mg) was performed within 30 days of chemical pleurodesis, achieving re-expansion of the lung by preventing recurrence of the effusion and leading to rapid clinical improvement. The novelty of the present case concerns the effectiveness of a combined treatment of fibrinolytic and intrapleural antibiotic through a pleural drainage after failure of chemical pleurodesis.
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series Monaldi Archives for Chest Disease
spelling doaj-art-d33e43ac145e4f4dbbfc746dfeb16eda2025-08-20T01:57:09ZengPAGEPress PublicationsMonaldi Archives for Chest Disease1122-06432532-52642025-05-0110.4081/monaldi.2025.3224Utility of chest ultrasound and intrapleural fibrinolytics with gentamicin following failed pleurodesisAldo Pezzuto0https://orcid.org/0000-0002-6626-2260Ferdinando Cozzolino1https://orcid.org/0009-0008-3218-7283Giosuè Amoroso2https://orcid.org/0009-0004-7166-4469Evohe Adone3Elisa Desideri4Alberto Ricci5Department of Cardiovascular and Respiratory Sciences, Sapienza University, Sant’Andrea Hospital, RomeDepartment of Cardiovascular and Respiratory Sciences, Sapienza University, Sant’Andrea Hospital, RomeDepartment of Cardiovascular and Respiratory Sciences, Sapienza University, Sant’Andrea Hospital, RomeDepartment of Cardiovascular and Respiratory Sciences, Sapienza University, Sant’Andrea Hospital, RomeDepartment of Cardiovascular and Respiratory Sciences, Sapienza University, Sant’Andrea Hospital, RomeDepartment of Cardiovascular and Respiratory Sciences, Sapienza University, Sant’Andrea Hospital, Rome This is a case of a 65-year-old male patient who presented to our institution due to worsening dyspnea and respiratory failure development. The patient was admitted due to dyspnea at rest and chest pain. He had a recent medical history of lung cancer with malignant pleural effusion. The patient had already undergone pleural talc poudrage by thoracoscopy, which had not been effective. Indeed, the patient was found to have residual septate pleural effusion on ultrasound examination. A placement of transthoracic pleural drainage followed by intrapleural instillation of urokinase (100,000 units) and gentamicin (80 mg) was performed within 30 days of chemical pleurodesis, achieving re-expansion of the lung by preventing recurrence of the effusion and leading to rapid clinical improvement. The novelty of the present case concerns the effectiveness of a combined treatment of fibrinolytic and intrapleural antibiotic through a pleural drainage after failure of chemical pleurodesis. https://www.monaldi-archives.org/macd/article/view/3224Septate pleural effusionchemical pleurodesisintrapleural fibrinolysispleural drainagechest ultrasonography
spellingShingle Aldo Pezzuto
Ferdinando Cozzolino
Giosuè Amoroso
Evohe Adone
Elisa Desideri
Alberto Ricci
Utility of chest ultrasound and intrapleural fibrinolytics with gentamicin following failed pleurodesis
Monaldi Archives for Chest Disease
Septate pleural effusion
chemical pleurodesis
intrapleural fibrinolysis
pleural drainage
chest ultrasonography
title Utility of chest ultrasound and intrapleural fibrinolytics with gentamicin following failed pleurodesis
title_full Utility of chest ultrasound and intrapleural fibrinolytics with gentamicin following failed pleurodesis
title_fullStr Utility of chest ultrasound and intrapleural fibrinolytics with gentamicin following failed pleurodesis
title_full_unstemmed Utility of chest ultrasound and intrapleural fibrinolytics with gentamicin following failed pleurodesis
title_short Utility of chest ultrasound and intrapleural fibrinolytics with gentamicin following failed pleurodesis
title_sort utility of chest ultrasound and intrapleural fibrinolytics with gentamicin following failed pleurodesis
topic Septate pleural effusion
chemical pleurodesis
intrapleural fibrinolysis
pleural drainage
chest ultrasonography
url https://www.monaldi-archives.org/macd/article/view/3224
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